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Emergency Department Administration

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https://www.readbyqxmd.com/read/28941387/management-protocols-for-status-epilepticus-in-the-pediatric-emergency-room-systematic-review-article
#1
REVIEW
Cheuk C Au, Ricardo G Branco, Robert C Tasker
OBJECTIVE: This systematic review of national or regional guidelines published in English aimed to better understand variance in pre-hospital and emergency department (ED) treatment of status epilepticus. SOURCES: Systematic search of national or regional guidelines (January 2000 to February 2017) contained within PubMed and Google Scholar databases, and article reference lists. The search keywords were status epilepticus, prolonged seizure, treatment, and guideline...
September 20, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28936143/assessment-of-readiness-of-academic-emergency-departments-in-the-central-region-of-saudi-arabia-to-receive-a-sick-child
#2
Fahad Saleh Alhajjaj, Abdullah Saleh Aldamigh
OBJECTIVE: We sought to assess the readiness of general emergency departments (EDs) in academic hospitals in the central region of the Kingdom of Saudi Arabia (KSA) to manage pediatric patients using an international tool: The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association guidelines, which include facilities, personnel, safety, and other components. METHODS: We assessed eligible centers during multiple visits from January 2016 to May 2016 in which we inspected the EDs and conducted interviews with their respective leadership in which we independently recorded our observations...
July 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28933929/diagnostic-accuracy-of-two-food-insecurity-screeners-recommended-for-use-in-health-care-settings
#3
Jennifer A Makelarski, Emily Abramsohn, Jasmine H Benjamin, Senxi Du, Stacy Tessler Lindau
OBJECTIVES: To test the diagnostic accuracy of the American Academy of Pediatrics (AAP) recommended food insecurity screener. METHODS: We conducted prospective diagnostic accuracy studies between July and November 2016 in Chicago, Illinois. We recruited convenience samples of adults from adult and pediatric emergency departments (12-month recall study: n = 188; 30-day recall study: n = 154). A self-administered survey included the 6-item Household Food Security Screen (gold standard), the validated 2-item Hunger Vital Sign (HVS; often, sometimes, never response categories), and the 2-item AAP tool (yes-or-no response categories)...
September 21, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28930937/administration-of-hypertonic-solutions-for-hemorrhagic-shock-a-systematic-review-and-meta-analysis-of-clinical-trials
#4
Meng-Che Wu, Tin-Yun Liao, Erica M Lee, Yueh-Sheng Chen, Wan-Ting Hsu, Meng-Tse Gabriel Lee, Po-Yang Tsou, Shyr-Chyr Chen, Chien-Chang Lee
BACKGROUND: Several clinical trials on hypertonic fluid administration have been completed, but the results have been inconclusive. The objective of this study is to summarize current evidence for treating hypovolemic patients with hypertonic solutions by performing a systematic review and meta-analysis. METHODS: Major electronic databases were searched from inception through June 2014. We included only randomized controlled trials involving hemorrhagic shock patients treated with hypertonic solutions...
September 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28930786/the-relationship-between-2009-pandemic-h1n1-influenza-during-pregnancy-and-preterm-birth-a-population-based-cohort-study
#5
Deshayne B Fell, Robert W Platt, Olga Basso, Kumanan Wilson, Jay S Kaufman, David L Buckeridge, Jeffrey C Kwong
BACKGROUND: Previous studies of maternal influenza illness and preterm birth have yielded inconsistent results. Our objective was to assess the association between 2009 pandemic H1N1 (pH1N1) influenza during pregnancy and preterm birth in a large obstetrical population. METHODS: We linked a province-wide birth registry with health administrative databases to identify influenza-coded hospitalizations, emergency department visits, or physician visits among pregnant women during the 2009 H1N1 pandemic (our proxy for clinical pH1N1 influenza illness)...
September 19, 2017: Epidemiology
https://www.readbyqxmd.com/read/28930037/regional-consolidation-of-orthopedic-surgery-impacts-on-hip-fracture-surgery-access-and-outcomes
#6
Sara A Kreindler, Lanette Siragusa, Eric Bohm, Wendy Rudnick, Colleen J Metge
BACKGROUND: Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. METHODS: We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28927481/a-system-wide-solution-to-antidote-stocking-in-emergency-departments-the-nova-scotia-antidote-program
#7
Nancy G Murphy, D Ruth Bona, Theresa A Hurley
OBJECTIVE: Inadequate stocking of essential antidotes in hospitals is an internationally documented problem. A concrete and sustainable system-wide solution for easy access to antidotes in emergency departments (EDs) was developed and implemented in Nova Scotia, Canada. METHODS: Antidote stocking guidelines and a systemwide antidote management strategy were established. A standardized collection of antidotes housed in highly visible containers in provincial EDs was implemented for timely access...
September 20, 2017: CJEM
https://www.readbyqxmd.com/read/28926508/racial-ethnic-variation-in-emergency-department-care-for-children-with-asthma
#8
Heather G Zook, Nathaniel R Payne, Susan E Puumala, Katherine M Ziegler, Anupam B Kharbanda
OBJECTIVE: To assess the variation between racial/ethnic groups in emergency department (ED) treatment of asthma for pediatric patients. METHODS: This study was a cross-sectional analysis of pediatric (2-18 years) asthma visits among 6 EDs in the Upper Midwest between June 2011 and May 2012. We used mixed-effects logistic regression to assess the odds of receiving steroids, radiology tests, and returning to the ED within 30 days. We conducted a subanalysis of asthma visits where patients received at least 1 albuterol treatment in the ED...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#9
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVE: We compared the tolerability and efficacy of intranasal sub-dissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared intranasal ketamine 1 mg/kg to intranasal fentanyl 1.5 μg/kg in children 4-17 years old with acute pain from suspected, isolated extremity fractures presenting to an urban level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28923103/moderate-sensitivity-and-high-specificity-of-emergency-department-administrative-data-for-transient-ischemic-attacks
#10
Amy Y X Yu, Hude Quan, Andrew McRae, Gabrielle O Wagner, Michael D Hill, Shelagh B Coutts
BACKGROUND: Validation of administrative data case definitions is key for accurate passive surveillance of disease. Transient ischemic attack (TIA) is a condition primarily managed in the emergency department. However, prior validation studies have focused on data after inpatient hospitalization. We aimed to determine the validity of the Canadian 10th International Classification of Diseases (ICD-10-CA) codes for TIA in the national ambulatory administrative database. METHODS: We performed a diagnostic accuracy study of four ICD-10-CA case definition algorithms for TIA in the emergency department setting...
September 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28917437/effects-of-intravenous-administration-of-fentanyl-and-lidocaine-on-hemodynamic-responses-following-endotracheal-intubation
#11
Amir Masoud Hashemian, Hamid Zamani Moghadam Doloo, Maziar Saadatfar, Roya Moallem, Maryam Moradifar, Raheleh Faramarzi, Mohammad Davood Sharifi
OBJECTIVES: To compare the effects of intravenous fentanyl and lidocaine on hemodynamic changes following endotracheal intubation in patients requiring Rapid Sequence Intubation (RSI) in the emergency department (ED). METHODS: A single-centered, prospective, simple non-randomized, double-blind clinical trial was conducted on 96 patients who needed RSI in Edalatian ED. They were randomly divided into three groups (fentanyl group (F), lidocaine group (L), and fentanyl plus lidocaine (M) as our control group)...
July 21, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28916424/predictors-of-epinephrine-dispensing-and-allergy-follow-up-after-emergency-department-visit-for-anaphylaxis
#12
Megan Motosue, M Fernanda Bellolio, Holly K Van Houten, Nilay D Shah, Ronna L Campbell
BACKGROUND: National guidelines recommend that patients with anaphylaxis be prescribed an epinephrine auto-injector (EAI) and referred to an allergy/immunology (A/I) specialist. OBJECTIVE: To evaluate guideline concordance and identify predictors of EAI dispensing and A/I follow-up in patients with anaphylaxis treated in the emergency department (ED). METHODS: We identified patients seen in the ED for anaphylaxis from 2010 through 2014 from an administrative claims database using an expanded International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code algorithm...
September 12, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28916120/does-early-and-appropriate-antibiotic-administration-improve-mortality-in-emergency-department-patients-with-severe-sepsis-or-septic-shock
#13
Robert Sherwin, Michael E Winters, Gary M Vilke, Gabriel Wardi
BACKGROUND: Severe sepsis and septic shock remain significant public health concerns. Appropriate emergency department management includes early recognition, hemodynamic resuscitation, source control, and prompt antibiotic administration. Current international guidelines strongly recommend administration of early and appropriate antibiotics for patients with severe sepsis and septic shock. Interestingly, a recent Cochrane Review found insufficient evidence to provide a similar recommendation on antibiotic administration...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28911896/patient-selection-and-outcomes-of-transfemoral-transcatheter-aortic-valve-replacement-performed-with-monitored-anesthesia-care-versus-general-anesthesia
#14
Saroj Pani, John Cagino, Paul Feustel, Sridhar Reddy Musuku, Asim Raja, Natalie Bruno, Christopher Ursillo, Nathapong Arunakul, Constantine M Poulos, Michael Welljams-Dorof, Kevin Roberts, Mikhail Torosoff, Augustine Delago
OBJECTIVE: The aim of this study was to compare outcomes of monitored anesthesia care (MAC) versus general anesthesia (GA) for transfemoral transcatheter aortic valve replacement (TF-TAVR) and to describe a selection process for the administration of MAC. DESIGN: Retrospective analysis of patients who underwent TF-TAVR under MAC or GA. SETTING: Department of Cardiac Anesthesia, Albany Medical Center, a tertiary university hospital. PARTICIPANTS: Patients selected for TF-TAVR...
April 5, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28904912/assessment-of-anxiety-level-of-emergency-health-care-workers-by-generalized-anxiety-disorder-7-tool
#15
Nesrin Alharthy, Osama Abdulrahman Alrajeh, Mohammed Almutairi, Ahmed Alhajri
BACKGROUND: Dealing with emergency patients is considered to be a stressful situation to all health-care workers in the emergency department (ED). Prolonged stress predispose to physical and inconsequential psychiatric disturbances. Anxiety and depressive mode were found to be the most commonly experienced psychiatric manifestation among emergency health-care workers. The aim of this study is to screen and assess the severity of anxiety among health professionals working in ED. METHODS: Cross-sectional study design was used...
July 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28903578/mental-health-services-use-trends-in-canadian-veterans-a-population-based-retrospective-cohort-study-in-ontario
#16
Alyson L Mahar, Alice B Aiken, Heidi Cramm, Marlo Whitehead, Patti Groome, Paul Kurdyak
OBJECTIVE: A substantial evidence base in the peer-reviewed literature exists investigating mental illness in the military, but relatively less is documented about mental illness in veterans. This study uses provincial, administrative data to study the use of mental health services by Canadian veterans in Ontario. METHOD: This was a retrospective cohort study of Canadian Armed Forces and Royal Canadian Mounted Police veterans who were released between 1990 and 2013 and resided in Ontario...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28900771/health-concerns-and-health-service-utilization-in-a-population-cohort-of-young-adults-with-autism-spectrum-disorder
#17
Jonathan A Weiss, Barry Isaacs, Heidi Diepstra, Andrew S Wilton, Hilary K Brown, Caitlin McGarry, Yona Lunsky
Individuals with autism spectrum disorder (ASD) have many health needs that place demands on the health service sector. This study used administrative data to compare health profiles in young adults 18-24 years of age with ASD to peers with and without other developmental disability. Young adults with ASD were more likely to have almost all the examined clinical health issues and health service use indicators compared to peers without developmental disability. They were more likely to have at least one psychiatric diagnosis, and visit the family physician, pediatrician, psychiatrist, and emergency department for psychiatric reasons, compared to peers with other developmental disability...
September 13, 2017: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/28899594/delayed-detection-of-spontaneous-bilateral-tubal-ectopic-pregnancies-after-methotrexate-treatment
#18
Nicole E Brown, Shereen A Singer, Joe Suyama
BACKGROUND: Bilateral tubal ectopic pregnancies are a rare subset of ectopic pregnancy that can pose a diagnostic dilemma for clinicians. There is no distinct clinical presentation for bilateral tubal ectopic pregnancies, although they are typically associated with assistive reproductive techniques. In addition, there is no single diagnostic feature to help clinicians delineate bilateral tubal ectopic pregnancies from other types of ectopic pregnancy prior to passing the discriminatory zone (such as heterotopic pregnancy or twin ectopic [two gestational sacs in one tube])...
September 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28890066/ascending-aorta-endovascular-repair-of-a-symptomatic-penetrating-atherosclerotic-ulcer-with-a-custom-made-endo-graft
#19
Theodoros Kratimenos, Nikolaos G Baikoussis, Dimitrios Tomais, Michalis Argiriou
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become lately the procedure of choice in the treatment of most pathologies of descending thoracic aorta. Aortic arch aneurysms also came to be treated by TEVAR with various hybrid techniques or custom made scalloped/fenestrated stent-grafts. Zone 0; ascending TEVAR is more challenging than TEVAR of the descending thoracic aorta or aortic arch because of the more complex pathology, hemodynamics, and anatomy. Ascending TEVAR can be a lifesaving treatment in selected high surgical risk patients...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28888253/further-evaluation-of-factors-that-may-predict-biphasic-reactions-in-emergency-department-anaphylaxis-patients
#20
Sangil Lee, Alexa Peterson, Christine M Lohse, Erik P Hess, Ronna L Campbell
BACKGROUND: Anaphylaxis is a systemic allergic reaction that is commonly treated in the emergency department (ED). The risk of a biphasic reaction is the rationale for observation. OBJECTIVE: To derive a prediction rule to stratify ED anaphylaxis patients at risk of a biphasic reaction. METHODS: We conducted an observational study of a cohort of patients presenting to an academic ED with signs and symptoms of anaphylaxis. We collected clinical data on biphasic reactions meeting National Institutes of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network diagnostic criteria...
September 2017: Journal of Allergy and Clinical Immunology in Practice
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